Knock, knock?

Is anyone still out there??  

So, yes, it's been forever.  I felt pretty good for about a year, working on motility, gut healing and rebuilding my gut microbiome.  Then the election happened and I won't get political but I just tanked from all the stress.  First, my thyroid took a nose dive and I started pushing into Reverse T3.  Worked to get that sorted out, eventually just throwing in the towel and switching from NDT (natural dessicated thyroid) back to Cytomel.  The muscle cramping didn't go away and the itching came back, which are my body's major SIBO signs.  I'm on so many prokinetics that I have the digestion stuff down so it's the only way my body can cry wolf. On New Year's Day I broke down and did a breath test.  Hello Methane!  

Baseline was so much higher than it's ever been.  Super discouraging and I knew I had to know for sure.  Was my IBS due to the two bouts of food poisoning I had in 2010??  I printed out the lab requisition for the IBSChek and presented it to my ND.  Results came back positive on both measures meaning yes, I have had food poisoning and yes, this SIBO is autoimmune in nature.  Even though the events were nearly 7 years ago I still have antibodies well over the cutoff.  Drat!

We know that when SIBO is autoimmune there's not a heck of a lot you can do until the antibodies clear but I added Lion's Mane and Acetyl L-Carnitine back in to support nerve regeneration.

I opted to do Chris Kresser's SIBO protocol because I've tried many of the others.  90 days of GI-Synergy, biofilm disruptors (lauricidin and Interfase plus), probiotics (Megaspore, PrescriptAssist and Ideal Bowel Support) and hydrolyzed guar gum.

Retest last week...

A big ole...  let down.  Are things better?  Yes!  Have my symptoms reduced?  Yes!  Did I expect more from 90 days of protocol?  Hell YES!

So for now I'm trying Atrantil as I hear for some it can really help with methane.  I'm also playing around with fasting.  Not elemental diet, plain old broth only fasting a couple of days here and there.  I feel pretty darn good.  I have a bag of the ITI ED (Integrative Therapeutics Elemental Diet) sitting in my cupboard but I've heard so many stories of "now I have SIFO" or "now I have a horrible yeast problem and it's worse than SIBO", that I'm seriously scared of the stuff.  I do not tolerate carbs or sugars very well at all so there's that too.  Not sure I could stomach going the homemade elemental diet again and that seems to be the only way you can control the amount of carbs.

Oh and can I just say Biohealth rocks for breath testing - Quintron machine, 3 hr lactulose, I did my test on Monday and had the results by Thursday morning.  I NEVER have to go through NCNM/NUNM again.  Woot! Woot!

Results finally - Breath Test #8

Results from May 2015. Breath test number 7.

Results from this month after gacking down guar gum with my herbal kill supplements.  

Not really what I was expecting given that my C and bloating have pretty much resolved. I'm still trying to wrap my head around it.  And it's not negative (like it says) because any methane at or above 3 is positive and really you shouldn't have any methane at all. And if there were no methanogens to eat the hydrogen gas, the hydrogen numbers would be higher. That said, I'm not having any real SIBO symptoms, maybe a little mild bloating throughout the day but not enough to change what I wear (I'm really self conscious when I have a gut and great at hiding it).  I am having D which is a super nice change.  Those with C understand :)

AND notice the date tested is 10/17, a full 10 days ago.  I sent an email questioning why I didn't get the results sooner, especially since I called on the 21st and was told they weren't ready.  Their response:

Hi Shari,

Our turn around time for sending results to the ordering provider for tests taken with kits at home is no later than 2 weeks from the date the completed kit is received in the lab. After samples are tested, they also must be interpreted and the results finalized before we release the results. This depends on how many other kits we received ahead of your kit.

We also do not release results directly to patients unless/until we receive a signed release of information form.

For SIBO tests taken here at the clinic, the turn around time for results is faster, either same day or next day.

Let us know if you have any other questions.

Best,

Audra
--
Audra Lee, M.S.
NCNM SIBO Lab
P 503-552-1931
F 503-444-6709

My response was along the lines of "the numbers are the numbers", it's not like they add any sort of interpretation or add a narrative or really anything.  I also may have said I recommend to others in the SIBO community that they find another lab with a reasonable turnaround time :)

Okay, enough ranting!!  

I'm good where I am so I'm just going to sit on it for awhile, continue with the MegaSpore and hope that the hype is right and it does contain the number one strain used in Europe to treat SIBO.  Although I've never seen anyone from Europe actually talk about MegaSpore or using probiotics in the forums (I guess if their SIBO is gone they wouldn't need to be there too!).  I'll stick with low FODMAPs for at least 6 weeks and decide what to do then.  Until then I'll focus on getting my adrenals and thyroid noodled out.  My worry is until this infecton is gone nothing else will heal.  Guess time will tell!

New Protocol - Repair

Just to remind all of you, I am not a healthcare provider of any kind.  I just do a little research and add what I feel works for me.  SIBO is such a strange animal so you have to figure out (hopefully with a qualified provider) what works for you.

I've decided to work on gut repair and motility since my reactions to foods are mostly in the form of belly itchiness which I contribute more to permeability and not SIBO per se.

I should also note that there is a bit of a brouhaha right now about FCO (fermented cod liver oil).  You can read about it here (and in many other places).  I am opting to continue with my bottle but not sure I will buy it again.  It's fairly difficult to keep fish oils from becoming rancid and they are expensive.  It's better to include some fatty fish in your diet a couple of times a week.  If you've been following along you might remember that on my Array 10 I am reacting to salmon, tilapia, trout, tuna, squid, and shrimp.  I did not react to sardines but for some reason they are making me nauseaus when I eat them.  My guess is it's a placebo thing.

Pre-meals     
Bitters (2 droppers)

Iberogast (2 droppers)

Red Yeast Rice       

LiverCare

Serrapeptase

Breakfast    
Multivitamin (2)

All-zyme

Magnesium Glycinate

Betaine HCL (1-2)

Fermented Cod Liver Oil

Vit C

Vit D 4000 iu (2 drops)

Vit K-2

Thyrosol

Adrenomend (2 capsules)

OrthoBiotic (every other day)

                  

9-10AM
T3 – 22.5mcg

Primal Defense (on days when no OrthoBiotic)

L-Glutamine (1)

GastricSoothe (2)

                  
Lunch           
Multivitamin (2)

All-zyme (1)
Magnesium Glycinate

Betaine HCL (1-2)

Vit C

PrescriptAssist (1)

Adrenomend (2 capsules)

Adrenaplex (2 capsules)

Dinner         
Multivitamin (2)

All-zyme (1)

Betaine HCL (1-2)

Magnesium Glycinate

Fermented Cod Liver Oil

Thyrosol (1 tablet)

Turmeric

9pm             
LDN – 5mg

Motilpro (3)

GastricSoothe (2)

L-Glutamine

Lion’s Mane (2)*

Magnesium Citrate (PRN)

*I haven't added the Lion's Mane in.  I added in the Motilpro last night and will add the GastricSoothe in tonight.  I've been taking Endozin for a while so shouldn't have a problem with the L-Glutamine and GastricSoothe since it's the same ingredients.  In a few days if all goes well I will add in the Lion's Mane.

Weight and bloat SLOWLY resolving..

It would be so nice if all the weight and the bloat disappeared as quickly as it comes on.  2 lbs of water weight went away pretty quickly after my half bottle of wine but the big ole belly has been hanging around.  I BINGED on chocolate yesterday, like 5 mini homemade mini Reeses peanut butter cups AND a whole chocolate mint pie from Whole Foods.  This morning my belly is down to normal size and I've even come down another 1/2 lb.  Imagine if chocolate were the cure!  LOL!

So with this bloat my mind has been busy contemplating options.  I have 5 days of Rifaximin in my cabinet and a bunch of Allicin.  I know a few people who are trying the Guar Gum (up to 1 tsp) 20-30 minutes before you take your antimicrobials.  I'm intrigued to say the least. My numbers are low but my symptoms indicate the need for continued treatment.  I'm also contemplating Candibactin AR & BR.  I tested positive for thyme (on the Array 10) but I cut it out for several weeks and recently had it in a batch of soup and did not react so I may be good to go.  We obviously know the fish is still a no go.

In the meantime I am adding the OrthoBiotic back in with breakfast to see how it goes and have ordered Motilpro to add in at bedtime.  Serrapeptase will be added before meals, it may help break down biofilms and even if it doesn't it helps with protein digestion which I still need. I am continuing with the Endozin (Zinc-Carnosine and L-Glutamine) and the PrescriptAssist at lunchtime.  So rebuild, refeed and keep sweepin'.

Almost there

Back to my diet, back to my walks, back to yoga, back to probiotics.  I'm almost back to normal. I keep forgetting to drink my probiotic tonic shots with breakfast and lunch but I put my pill form probiotics in with my meal supplements so I know I am getting those in.  I am taking Ortho Biotic with breakfast and PrescriptAssist with lunch.  I'll definitely be packing them on our trip next week (more camping, more mountain biking, a water park and a dude ranch).  When I get back I'll rotate them out and add Primal Defense back in.  I think it's good to switch things up.  I need to place another order for MegaSpore Biotic since that one seems to take the longest to get.  I'm also slowing tapering off my current kill protocol as I run out of supplements.  I'll keep just keep on with the biofilm and cell wall disrupters.

Oh, and I'm tapering off my thyroid medication and then I'll test my thyroid to see how it's holding up.  Hopefully my conversion from T4 to T3 has improved with the addition of Thyrosol (a Metagenics product specifically designed for supporting conversion).

I think I'm almost there....

Was it the Red Rice Yeast or the addition of a crapton of probiotics??? I'm not sure but my guess is it's a combination of both.  I have been taking Red Rice Yeast with the herbal biotics (Biocidin, Oliverix, garlic in some form and for 10 days oreganol) before every meal. I drink the juice from sauerkraut with breakfast, just a shot.  Between breakfast and lunch I am taking 1/3 tsp of Garden of Life Primal Defense in water (blech!).  I am taking a soil based probiotic (PrescriptAssist) or MegaSpore Biotic with lunch.  Then I lay off because in my experience if I do any probiotics after dinner I generally wake up in the middle of the night bloated.

I'm also being really good about not eating anything that I could be sensitive too which is really hard since we traveled over the weekend.  Does this mean my inflammation is down too?? Hopefully yes and it definitely seems so.

My gut has been happy.  My kid and I stopped at the Alberta cart Cultured Caveman in Portland, OR last weekend and there were 3 other food carts there that were either vegan or paleo, which means no dairy.  I'm pretty sure all the trucks were gluten free as well.  We ate like piggies - chicken strips, ice cream, donuts (2 orders), and a fudge bar. Not the healthiest but oh well.  The ice cream was strawberry-banana and the fruit chunks were a little big for his liking so I ate it. Bananas!  I ate banana with no reaction.  Everything did hit my stomach like a brick but I ate a ton of heavy, fatty food so that's reasonable :)  I have been eating cashew cheese too.  I was missing my cheezy kale chips.  No more.  And french fries!  Too many french fries over the weekend :)

My hormones have not been so good.  I had a lot of stress last week, PMS through the roof and my body temperatures have plummeted.  I know it will resolve as my gut heals but it's hard to ride the wave sometimes while waiting. I went online to schedule a follow up with Dr. Keller but she has increased her prices to $250 for 30 minutes of skype so that's just not going to happen.  AND, the new policy is you can't get breath test results without a consult with her.  In the past I was able to order tests and get results whenever I want.  Ah well, I have a local ND and I can get the tests through him, it's just more annoying because he travels and teaches a lot.  Anyway, I searched online and found both thyroid and adrenal support that is similar to what I was taking.

This webinar does really good at explaining how your gut can mess up your thyroid, adrenals, etc. etc.  I know nothing about the program and am not recommending you buy it but I did think the information was worth watching.  The link will expire on Monday, July 20th.

Next up.... adding in Lion's Mane (which seems to be on sale everywhere right now, which I took as a sign :) to help support rebuilding the nerves in the gut.

Then maybe in a few months I can start adding in resistant starch.  YIKES!

Interesting perspectives on SBO's and gut healing

On the pro side there's this:
soil-based-probiotics-plus-fermented-foods-heal-gut

And on the con side:
the-problem-with-soil-based-organisms

We go 'round and 'round about this and the bottom line seems to be no one really knows for sure.  Bottom line seems to be, proceed with caution!